Healthcare Provider Details

I. General information

NPI: 1336386796
Provider Name (Legal Business Name): GAYLE STRIAR HERMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24302 NORTHERN BLVD
DOUGLASTON NY
11362-1150
US

IV. Provider business mailing address

24302 NORTHERN BLVD
DOUGLASTON NY
11362-1150
US

V. Phone/Fax

Practice location:
  • Phone: 718-423-6200
  • Fax: 718-423-9762
Mailing address:
  • Phone: 718-423-6200
  • Fax: 718-423-9762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberP73453
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: